Respiratory polygraphy with actigraphy in the diagnosis of sleep apnea-hypopnea syndrome
Respiratory polygraphy with actigraphy in the diagnosis of sleep apnea-hypopnea syndrome
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DOI：
10.1378/chest.06-1604
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发表时间：
2007-03-01
期刊：
影响因子：
9.6
通讯作者：
Capote, Francisco
中科院分区：
文献类型：
--
作者：
Garcia-Diaz, Emilio;Quintana-Gallego, Esther;Capote, Francisco
目的：探讨呼吸多导描记设备(Apnoescreen H；Erich Jaeger GmbH&CoKG；德国维尔茨堡)在睡眠呼吸暂停低通气综合征(SAHS)诊断中的实用性和可靠性。设计：一项前瞻性、随机、盲法研究。患者：62例可疑SAHS患者。测量：以下两项RP研究：一项在睡眠实验室(睡眠实验室RP[LRP])，同时进行多导睡眠图；另一项在家中(RP[HRP])。结果：在LRP中，以动态睡眠图(RDI)估计的总睡眠时间为分母计算呼吸紊乱指数，其敏感性在94.6%~100%之间，特异性在88%~96.7%之间。以总记录时间(RDITRT)计算呼吸紊乱指数时，敏感性略低(91.6%~96.9%)，特异性相近(92%~96.7%)。RDI诊断HRP的灵敏度为83.8%~95.8%，特异度为92%~100%；RDITRT的灵敏度为83.8%~87.5%，特异度为94.7%~100%。在观察者间可靠性方面，两种RP分析的RDI在LPR和HPR中的组内相关系数均为0.99。结论：HPR是诊断SAUS的一种有效而可靠的技术，尽管它不如LRP敏感。腕部活动描记术仅略微改善了HRP的结果。
Objective: To determine the utility and reliability of a respiratory polygraphy (RP) device with actigraphy (Apnoescreen H; Erich Jaeger GMBH & CoKg; Wuerzburg, Germany) in the diagnosis of sleep apnea-hypopnea syndrome (SAHS).Design: A prospective randomized study with blinded analysis.Patients: Sixty-two patients with suspected SAHS.Measurements: the following two RP studies were performed: one in the sleep laboratory (sleep laboratory RP [LRP]), simultaneously with polysomnography; and the other at home (home RP [HRP]). To study the interobserver reliability of RP, two manual analyses were carried out by two different researchers.Results: In LRP, when the respiratory disturbance index was calculated using the total sleep time estimated by actigraphy (RDI) as a denominator, the sensitivity ranged between 94.6% and 100%, and the specificity between 88% and 96.7% for the different cutoff points of the apnea-hypopnea indexes studied. When the respiratory disturbance index was calculated according to the total recording time (RDITRT), the sensitivity was slightly lower (91.6 to 96.9%) and the specificity was similar (92 to 96.7%). In HRP, the sensitivity of the RDI ranged between 83.8% and 95.8%, and the specificity between 92% and 100%, whereas, when the RDITRT was used, the sensitivity was between 83.8% and 87.5%, and the specificity was between 94.7% and 100%. With regard to interobserver reliability, the intraclass correlation coefficient for the RDI of the two analyses of the RP was 0.99 for both LPR and HPR.Conclusion: HPR is an effective and reliable technique for the diagnosis of SAUS, although it is less sensitive than LRP. Wrist actigraphy improves the results of HRP only slightly.